Papel de las enfermeras en reproducción asistida: dimensión emocional / The role of nurses in Assisted Reproduction: the emotional dimensión

OBJETIVO: analizar y actualizar el papel que llevan a cabo las enfermeras en el ámbito de la reproducción humana asistida desde la perspectiva psicosocial. MÉTODO: revisión narrativa mediante búsqueda bibliográfica en las bases de datos PubMed, Cuiden, Red SciELO, Cochrane Plus y Cinahl, con lenguaje libre y controlado (términos MeSH), utilizándolos operadores booleanos y, en algunos casos, el truncado. La búsqueda se limitó a artículos publicados entre 2004 y 2014. Se seleccionaron 10 artículos en total, en función de los criterios de inclusión y exclusión establecidos. RESULTADOS: se identificaron cinco categorías de análisis: el apoyo emocional, la labor educativa y la formación, la continuidad de los cuidados, la relación enfermera-paciente y el trabajo en equipo. Las enfermeras llevan a cabo un rol múltiple, proporcionando cuidados holísticos a las mujeres y parejas que reciben técnicas de reproducción asistida (TRA), siendo un proceso notablemente costoso en el ámbito emocional. CONCLUSIONES: las enfermeras se presentan como unas profesionales imprescindibles en las Unidades de Reproducción Asistida(URA) para proporcionar una asistencia sanitaria de calidad. Es necesario aplicar los últimos avances a la práctica clínica, fomentarla utilización de la metodología enfermera y promover la labor investigadora en esta temática

OBJECTIVE: to review and update the role performed by nurses in the setting of Human Assisted Reproduction from a psychosocial perspective. METHOD: a narrative review through bibliographic search in the following databases: PubMed, Cuiden, Red SciELO, Cochrane Plus and Cinahl, with free and controlled language (MeSH terms),using boolean operators, and truncation in some cases. The search was limited to articles published between 2004 and2014. Ten articles were selected in total, based on the established inclusion and exclusion criteria. RESULTS: five categories were identified for review: emotional support, educational activities and training, continuity of care, nurse-patient relationship, and team work. Nurses conduct a multiple role, providing holistic care to those women and couples who receive Assisted Reproduction Techniques (ARTs), which represents a significantly difficult process in the emotional setting. CONCLUSIONS: nurses appear as indispensable professionals in the Assisted Reproduction Units (ARUs), in order to provide high quality healthcare. It is necessary to implement the latest advances in clinical practice, to encourage the use of nursing methodology, and to promote research work within this subject

Impact of a bilingual education intervention on the quality of life of Latina breast cancer survivors.

PURPOSE/OBJECTIVES: To test the effectiveness of a bilingual education intervention to improve the quality of life (QOL) of Latina breast cancer survivors (BCSs) after completing primary treatment for breast cancer. DESIGN: A two-group prospective, longitudinal, randomized, controlled trial. SETTING: An ambulatory-care setting of a designated comprehensive cancer center in southern California. SAMPLE: 52 English- and Spanish-speaking Latina BCSs. METHODS: Women were randomly assigned to the experimental or attention control group and completed measures of QOL, uncertainty, distress, and acculturation at baseline, and at three and six months postintervention. MAIN RESEARCH VARIABLES: QOL, uncertainty, and distress. FINDINGS: After controlling for acculturation, the four dimensions of QOL increased slightly in the groups or remained unchanged without significant group-by-time interaction. The social and psychological well-being subscales had the lowest scores, followed by physical and spiritual well-being. Although the group-by-time interaction was not statistically significant, the post-hoc difference for total QOL between time 2 and time 3 in the experimental group approached significance, with a slight increase in total QOL. CONCLUSIONS: Latina BCSs have multiple survivorship and QOL concerns that might put them at risk for poor QOL. IMPLICATIONS FOR NURSING: More culturally congruent intervention studies are needed to address the paucity of intervention research with Latina BCS. KNOWLEDGE TRANSLATION: Core values must be incorporated in the development of health education programs. Those programs also should be linguistically appropriate and available to non-English-speaking Latinas. In this way, the informational and supportive needs of all BCSs can be met.

Provider verbal responses to patient distress cues during ambulatory oncology visits.

PURPOSE/OBJECTIVES: To explore healthcare provider cue-responding behaviors to patient cues of distress and socioemotional concerns during ambulatory, on-treatment oncology visits. DESIGN: Descriptive secondary analysis of a data set of audio recordings of oncology visits and reports of symptoms and quality of life recorded with an electronic self-report assessment-cancer (ESRA-C) tool. SETTING: Comprehensive cancer center, ambulatory care. SAMPLE: 31 randomly selected cases from an existing data set (with one used as a training tool) of 590 audio recordings of patient-provider communication. METHODS: Patients were placed in Group 1 (n = 20) and Group 2 (n = 10) to explore differences in patient-provider communication and decrease coder bias. Both groups completed the ESRA-C questionnaire prior to the visit. Providers in Group 2 received a printed ESRA-C summary report for use during the visit. Audio files of the visit were coded using the Medical Interview Aural Rating System (MIARS). MAIN RESEARCH VARIABLES: Patient cues of distress and provider cue-responding behaviors. FINDINGS: Patient cues of distress and socioemotional concerns ranged from 0-13 cues per visit, with a mean of 4.6 cues per visit. Providers acknowledged 57% of patient cues, but only acknowledged and explored 22% of all patient cues. Providers in Group 2 acknowledged patient concerns more often but explored the concerns less frequently. The number of patient cues distanced from by providers was lower in Group 2 and the overall provider score for responsiveness to patient cues of distress was higher, indicating more responsiveness than from Group 1. CONCLUSIONS: The use of a summary report of patient concerns may have enhanced provider responsiveness, in general. Distancing behaviors by providers in response to patient verbal cues may indicate a lack of knowledge, time limitations, or a lack of confidence. IMPLICATIONS FOR NURSING: To effectively support patients with cancer through active therapy, a greater level of acknowledgment, exploration, and responsive action by providers is indicated. These findings have implications for provider education, with regard to appropriate responses, and for researchers to test methods that best prompt and support effective provider behaviors, ultimately improving patient outcomes.

Procedural pain management: a position statement with clinical practice recommendations.

The American Society for Pain Management Nursing (ASPMN) has developed a position statement and clinical practice recommendations related to procedural preparation and comfort management. Procedures potentially produce pain and anxiety, both of which should be assessed and addressed before the procedure begins. This position statement refers to "comfort management" as incorporating the management of pain, anxiety, and any other discomforts that may occur with procedures. It is the position of ASPMN that nurses and other health care professionals advocate and intervene based on the needs of the patient, setting, and situation, to provide optimal comfort management before, during, and after procedures. Furthermore, ASPMN does not condone procedures being performed without the implementation of planned comfort assessment and management. In addition to outlining this position with supporting evidence, this paper reviews the ethical considerations regarding procedural comfort management and provides recommendations for nonpharmacologic and pharmacologic management during all phases of the procedure. An appendix provides a summary of this position statement and clinical practice recommendations.

Determinants of quality of life in patients near the end of life: a longitudinal perspective.

PURPOSE/OBJECTIVES: to describe the quality of life (QOL) of patients near the end of life and to identify determinants of their QOL. DESIGN: descriptive, longitudinal. SETTING: university-affiliated cancer center, two private oncologists' offices, and patients' homes. SAMPLE: 80 patients with either stage IIIb or IV lung cancer newly diagnosed in the previous month or recurrent lung cancer with distant disease. METHODS: patients were interviewed for responses to instruments to assess demographic, physical, psychosocial, and spiritual characteristics. Baseline data were collected at the patients' places of oncology care. Home visits were made for the two-month and four-month data collection points. MAIN RESEARCH VARIABLES: QOL; symptom frequency, severity, and distress; functional status; anxiety; depression. FINDINGS: fifty percent of patients died within five months of their lung cancer diagnosis. Patients reported a relatively high QOL that did not change significantly as they approached the end of life. Symptom distress was the strongest determinant of QOL, followed by symptom severity, symptom frequency, and depression. CONCLUSIONS: QOL was most affected by symptoms experienced in patients with advanced lung cancer, particularly distress associated with symptoms. Interventions for symptom management must be implemented at diagnosis because patients in this population may approach the end of life quickly. IMPLICATIONS FOR NURSING: a routine and thorough symptom assessment is imperative for patients with advanced lung cancer. Attention to symptom distress is important because of its effect on QOL.

A comparison of multisensory and traditional interventions on inpatient psychiatry and geriatric neuropsychiatry units.

Sensory rooms and the use of multisensory interventions are becoming popular in inpatient psychiatry. The empirical data supporting their use are limited, and there is only anecdotal evidence indicating effectiveness in psychiatric populations. The specific aims of this observational pilot study were to determine whether multisensory-based therapies were effective in managing psychiatric symptoms and to evaluate how these interventions compared to traditional ones used in the milieu. The study found that multisensory interventions were as effective as traditional ones in managing symptoms, and participants' Brief Psychiatric Rating Scale scores significantly improved following both kinds of intervention. Medication administration did not affect symptom reduction. This article explores how multisensory interventions offer choice in symptom management. Education regarding multisensory strategies should become integral to inpatient and outpatient group programs, in that additional symptom management strategies can only be an asset.